biomedicine’s reductionism, primary value of efficiency, and authority in mediating interpretations of health, illness, and suffering (Good 1994; Kleinman 1995); they point to the fact that physiological measures alone fail to capture the subjective dimensions of health. The growth of biomedicine, its characteristic quality of redefining social problems as health problems needing biomedical intervention, and its global cultural reach have also been analyzed. That biomedicine has been closely allied with the growth of industrial capitalism has led many ethnographers to examine biomedicine as a conduit of social regulations and discipline influencing all sectors of life, from definitions of disability to norms of occupational health, to definitions of mental illness and fitness (Turner 1995). This process has led to strong critiques regarding the necessity and indeed at times harmfulness of biomedical interventions, particularly with respect to the unpredictable side effects of technical procedures and drugs used to diagnose and treat patients. Concerns for iatrogenesis are reflected in current U.S. debates regarding the consumption of psychiatric drugs by pre-school children for example.
Attention to the international political economic context in which biomedicine operates is central to understanding how ideas of health modify, as well as to understanding the modes through which they are integrated as a set of values and practices in local contexts. Cross-cultural studies reveal the extent to which this integration with local experience is contested or resisted by highlighting: 1) the many discrepancies between biomedical knowledge and subjective accounts of illness and health, particularly in non-western countries; 2) the moral and religious tensions underlying choices of medical systems; 3) the degree to which distinctions between health and disease are rooted (or uprooted) by global ideologies and beliefs.
4. Biotechnology and Health
In response to the large influence that public health has achieved in our times many due to the advances of biomedicine and advances in technology, the power of state action in the public domain, and market forces, health has increasingly become a specialized domain. The history of public health has been marked by major advances in population-level health in the 19th and early 20th century, through sanitary and workplace improvements, housing, and nutrition. Public health has shifted priority from social medicine to individually targeted health promotion. The launching and completion of the largest biology project ever conceived – the mapping and sequencing of the human genome – has already accelerated this process of individualizing health vis a vis the genetic profiling of diseases and increased prognostic information. For example, silicon chips embedded with hybrid bits of DNA that can test for various genetic conditions in individuals are currently in development. Such diagnostic tools are refocusing